Why should I have a Bridge?

The reason for having a bridge is to restore a missing tooth (or teeth) and prevent the potential consequences of leaving the space as it is.

The advantages and disadvantages of having a bridge depend on what we are comparing the choice of a bridge to- be it a partial denture, an implant or simply doing nothing.

What are the Advantages of having a Dental Bridge?

Generally speaking, the main advantages of having a dental bridge are:

• Great looks (aesthetics) 

In a traditional fixed bridge, not only can you fill the space of the missing tooth, you can improve the colour and the shape of the teeth that you are crowning either side. This gives the technician a little more space to play with and allows a bit of flexibility in creating a desirable result. Porcelain looks great, matches the natural teeth exceptionally well and is very resistant to staining.

• Not removable

A bridge is fixed in your mouth- you don’t have to worry about taking it out to clean it like a partial denture. It is very important that you look after it and follow the special cleaning advice for bridges.

• Protective

If the teeth either side are heavily filled or broken down then by crowning these teeth as part of the bridge you are actually helping to strengthen them and replace your missing tooth at the same time.

• Long lasting 

Studies have shown that fixed bridgework, like individual crowns, is very predictable, durable and lasts a considerable length of time. That said, they aren’t as good as natural teeth and once your teeth are prepared for this type of bridge, there’s no going back. Your teeth will always need a crown/bridge. Should you opt for a resin-retained or bonded bridge, it would not be expected to last as long as another type of bridge.

• Relatively quick

A bridge in general takes only a little longer than a single crown (depending on the size and type of the bridge) and once the decision to make a bridge has been made, unless part of a more complex treatment plan, it takes just two appointments from start to finish. This is a much quicker procedure than having an implant or even a partial denture.

• Less invasive than implants

Implants require one or more surgical procedures to place the implant or implants. You may also require bone grafting if you have insufficient natural bone available. For anyone who is unable to undergo implant surgery for medical reasons, it is a great fixed alternative.

What are the Disadvantages of having a Dental Bridge?

The main disadvantages of having a dental bridge are:

• Destructive

If the tooth is completely natural, the preparation is quite damaging. In order to make space for the bridge the teeth must be filed down. Where a tooth has already been heavily damaged or has multiple or large fillings, this can actually have a protective role. Here we are assuming the retainer is a full crown- some dentists may use other less destructive retainers in certain cases . Not all types of bridge are quite as destructive, both the resin-retained bridge bridge and glass-reinforced fibre composite bridge are much more conservative- though not as strong or as predictable. A cantilever design may also help to preserve the maximum amount of natural tooth.

• Damaged nerves

When a tooth is prepared for a full crown, alone or as part of a bridge, 1-15% lose vitality (i.e. the nerve dies) and will require root canal treatment in the future. That is of course assuming a root canal has not already been carried out.

• Expensive

Single crowns are quite expensive, so with fixed bridgework, costs escalate quite dramatically. See- Bridge costs for a more detailed breakdown.

• A long appointment

The procedure for the bridge is quite a long. The first appointment could take anything from one to three hours depending on the dentist.The second appointment should be completed in about an hour.

• Difficulty cleaning

Some extra care is necessary to keep the underside of the bridge nice and clean, as it is prone to collecting plaque. Since the fake tooth is rigidly joined to the teeth either side it is not possible to floss in the normal way and super floss is needed.

Can I have a Dental Bridge?

There are the circumstances in which a dental bridge may not be sensible or even possible. These are the same for both crown and bridges.

In summary, the reasons you may not be able to have a bridge are:

• Finances don’t permit it
• Lack of space

Not enough space for the dentist to work or the bridge to fit.

• Serious medical conditions

Any medical conditions which stop you lying down, or staying still for the long appointments.

• Poor oral hygiene

If you can’t look after your mouth before having a bridge, chances are it will only make things worse.

• Poor periodontal support

Good solid teeth are needed to support a fake tooth. Where the bone support is poor, a bridge may cause more problems than it solves. If additional bone is lost from the extra pressures of supporting a missing tooth, the teeth will progressively loosen. Eventually they will be so loose or cause pain and need extracting, leaving you with a considerably bigger gap.

It may not be sensible to have a bridge if other options are more appropriate:

• Multiple missing teeth

These may be better restored with a partial denture, unless you can afford multiple bridges and implants as part of a full mouth rehabilitation.

• Healthy teeth

If you have two perfectly healthy teeth either side of the space, an implant crown would in most cases be the best option leaving these totally untouched.

• You are likely to lose more teeth

A tooth can be added to a partial denture without too much problem. This is not possible with a bridge, so if more teeth are likely to be lost – this should be planned from the start and taken in to account.

• Missing last molar tooth.

A bridge here is very difficult and often even unnecessary. An implant would be a better solution if you wanted the space restored with a fixed option.